The restrictions outlined by NHS England apply to medicines such as painkillers, indigestion remedies and anti-diarrhoea medications, which are available without a prescription, and can be purchased in supermarkets, petrol stations and convenience stores.  

The new guidelines will lead to a number of patients who were previously exempted from prescription charges such as older people, pregnant women and certain long-term health conditions being charged. Plus, the costs of items purchased ‘over the counter’ will be in addition to the pre-payment certificate. 

However, the NHS England guidance contains a number of exemptions, including for people with long-term conditions. However, that doesn't mean that if you have a long-term condition you will be automatically prescribed an OTC medication by your GP. The exemption applies in situations where the prescription is for treating or managing the long-term condition. 

It is also worth keeping in mind that the new guidance is not mandatory, and CCGs have the discretion to apply the guidance how they see fit (within reason). This will mean that local prescribing policies will vary across England. 

So, what does this mean for people living with Crohn’s and Colitis?

What these changes mean will depend on where you live. Local prescribing practices should be available to read on your local Clincal Commissioning Group’s (CCG’s) website. (Find your CCG). 

To support people living with Crohn's and Colitis to understand the changes, we have included some example scenarios, in which patients with Crohn's and Colitis should continue to be prescribed over the counter medications, if they live in an area where the CCG chooses to apply the guidance faithfully. 

Example scenario 1: ‘patients prescribed an OTC treatment for a long term condition’. 

In this scenario patients with Crohn’s and Colitis should continue to be prescribed over the counter medications to treat and manage symptoms of their IBD such as:  

• Antidiarrhoeals: loperamide (Imodium, Arret), codeine phosphate and diphenoxylate (Lomotil)  
• Antispasmodics such as mebeverine (Colofac), hyoscine butylbromide (Buscopan) and alverine citrate (Spasmonal)  
• Painkillers.  
• Bulking agents or ‘bulk formers’ e.g. ispaghula or stercula. Popular brands include Fybogel, Isogel and Normacol.  
• Bile salt binders.  
• Laxatives: osmotic laxatives, such as Movicol, Laxido, lactulose and senna.  
• Anti-foaming agents: e.g. Simethicone.  
• Anti-sickness medication.  
• Rehydration salts.  
• Indigestion remedies.  
• Haemorrhoid treatments.  
• Creams and treatments for associated skin conditions.  
• OTC treatments for associated eye conditions- like uveitis 

Example scenario 2: patients prescribed OTC products “to treat an adverse effect or symptom of a more complex illness and/or prescription only medications”. 

For example this should mean: 

• Sunscreen in cases where a patient is prescribed Azathioprine.  
• Calcium in cases where patients are prescribed a course of steroids. 
• Folic acid to help the body cope with methotrexate and help reduce some of the possible side effects, such as nausea and vomiting. 

Example scenario 3: People with IBD, who are immunosuppressed, should continue to have treatments prescribed for conditions such as cold sores. 

Example scenario 4: The prescribing of vitamins and minerals in the case of medically diagnosed deficiency, including for those patients who may have a lifelong or chronic condition or have undergone surgery that results in malabsorption.

For example: 

• Folic acid and zinc and magnesium supplements.  
• Sulphasalazine.  
• Higher dose of folic acid in pregnancy. 

Example scenario 5: Calcium and vitamin D for osteoporosis.

Any questions or concerns?

If you have any queries or concerns, we recommend that you raise them with your GP in the first instance. 

Unfortunately, we can't respond to individual cases, but we do want to hear about your experiences of these changes. If you would like to share your experience please email  us.